2003-09-18 - 2:35 p.m. - Cycle day:

Finally finished writing up my birth story. I'll have to come back later and fill in some of the post-partum details, but here's how the 24 hours preceding M's birth went down ...

I went to my OB appointment on Wednesday, which was in the middle of my 41st week of pregnancy. I was measuring right on target for my gestation, and had a slightly dilated and fairly well effaced cervix. I was, as they say, “ripe.” My doctor wasn't concerned that I hadn't yet delivered, but for the first time he mentioned what steps we might take the next week if things still hadn't progressed. I was really hoping to avoid any sort of artificial induction method, so this news was a little disconcerting. I talked to The Doula that afternoon and she helped calm me down and reassure me that the baby would come soon. She suggested that I try my best to relax, so I went for a walk that night, took a long, hot bath and had The Husband rub my feet before settling into bed at a fairly early hour. I felt peaceful and more confident that my body would make things happen in its own time.

Wednesday night was restless, but I woke up on Thursday feeling wide-awake. When I made my first morning trip to the bathroom, I realized that I'd lost at least part of my mucus plug (the cork in the womb's bottle, so to speak). I tried not to get too excited, because I knew that I could still have a few days before labor really started, but I couldn't help thinking that things may really be underway. I kept thinking I was feeling twinges in my belly, but then would talk myself into believing that they were imagined. I started my work day and tried to focus on other things, but as the morning wore on, I noticed that the twinges seemed to be coming pretty regularly, whether I thought about them or not. I talked to my mom and my friend N., and they both seemed to agree that this was really what I thought it was. I figured I had better wrap things up at work, so I sent out a few emails hinting at my imminent condition and then pretty much spent the rest of the afternoon working through early labor.

Well, that and waiting for the cable modem repairperson who was supposed to come by between 1 and 5. I really wanted to take a hot bath or get in a good nap, but I kept waiting for the doorbell to ring (which it never did - thanks a lot, Time Warner). Instead, I tried to stay comfortable, which meant a lot of time sitting on or draping myself over the birth ball. I called The Doula and gave her the status report. She was confident that the baby was coming, although she did warn me that there could still be another day or so of this type of labor. We agreed that I'd call her when things got more intense.

So where was The Husband during all this? At this point, still at work, unaware of what was going on at home. He had a class to teach Thursday morning, so I didn't feel a need to interrupt. Then I figured I'd let him get things done without the distraction of knowing the baby was on its way. I finally talked to him around 12:00 and told him what was happening, but also told him it was okay for him to stay there and get things in order. He had an evening class scheduled for that day, so he went on preparing for that. He would have come home in a second if I'd asked him to, but I was sort of in that cat-hiding-behind-the-toilet stage of labor, and I was doing just fine by myself. I knew that he'd be anxious (understandably), and I was trying to keep a nice, relaxed vibe going. So he stayed at school and checked in regularly throughout the day, and I kept working through contractions that were coming about twenty minutes apart.

The afternoon blended into the evening. I walked around, laid down when I could, chatted with friends online when I felt comfortable. I snacked a lot and drank water pretty much constantly, which is a big change from my typical hydrophobic routine. The Husband

and I decided it was okay for him to teach his evening class, although he promised to keep it short. Sure enough, he was home around 7:00, an hour and a half before the class's scheduled end time. By then, my contractions were about ten minutes apart and

getting noticeably stronger, although I could still walk around and talk through them. I took a few phone calls, kept eating and drinking, and tried not to keep an eye on the clock. I was doubting myself when I wrote down my own times, so I would call out to The Husband when I was having a contraction and he would write down when it started. The spacing went to nine minutes, then seven. We thought we should get some rest, but I wanted to try to eat something with a little substance first. I had been craving an egg salad sandwich all day but hadn’t been able to make one because we were out of mayonnaise. The Husband brought some back on his way home from work, so I boiled a couple eggs and made one up. Sadly, I got my proportions wrong and it tasted pretty bad. That was the last thing I ate.

We got into nightclothes and tried to rest, but I was too uncomfortable lying down while the contractions were happening, so it was pretty pointless. Around 11:30, the contractions were about six minutes apart and I was having trouble doing anything but deep breathing while they peaked, so we decided to call The Doula. She was over about half an hour later and watched me go through a few contractions to assess my status. I was still pretty composed at that point - I was doing nice, effective breathing and walking/rocking gracefully during each rush. The Doula helped keep the environment calm and peaceful, even though we were all anxious to see what would happen next. Thanks to all the water, I was going to the bathroom pretty often, and shortly after The Doula arrived, I lost the last of my mucus plug and finally observed the "bloody show" that usually accompanies this. I was spotting pretty heavily from then on, and soon after that, we realized that I was having double contractions - just when I thought one was over, another would come right up behind it. I could tell that The Husband and The Doula both wanted to get to the hospital, but I think my nervousness about sitting through the drive made me hold off a while longer. I finally gave in around 1:00 am and we got ready to go. We stepped outside at 1:23, and just as I sent The Husband back inside to get the bottled drinks we forgot to grab, my very considerate water broke all over the front porch. I squish-waddled back inside to change shorts and shoes, and then we officially got on our way.

Thankfully, the roads were almost entirely empty, because that was not the safest drive we ever took. The Husband only ran one red light, when a signal refused to give us a green left turn arrow, but he was on edge and going as fast as he felt he could. My contractions felt more intense, partly from being in a sitting position and partly from having my water gone. I began low moaning through each rush instead of just deep breathing. Whenever I felt one coming on, I braced my arms straight down and tried to get as close to an unbent position as I could. I started getting really hot, and my legs began to shake, so I had a pretty good idea that I was in transition. My eyes were closed for most of the drive, because I didn't really want to know how far we were from the hospital. I only really opened them a few times, one of which was when The Husband took a corner like an Indy driver. I think that was after I said "I feel like I need to push," although The Husband swears that I said "Can I push now?" Either way, he accurately gauged that things were getting more urgent. So when we got within a mile of the hospital and saw the train tracks in front of us, I think we both thought the same thing - "We'll beat the train if we have to." Fortunately, we didn't, although the flashing red lights from the off-hours traffic signal made us sure that we would.

We got to the hospital, but the ride wasn't over quite yet. The Husband had forgotten that we had to use the Emergency entrance because of our late-night arrival, so in between moans, I was trying to tell him we needed the other door. When he figured out what I was saying, he then got all turned around and had to do a few circles to wind our way back to the ER parking lot - with The Doula confused but following the entire time.

And then the real work began. We got inside, and of course had to sign some papers and answer questions and go through the whole ER triage system. The Doula and The Husband did their best to keep my involvement to a minimum, although The Husband was fairly hard-pressed to answer questions about my social security number or height. It felt like it took forever, but looking back, I can appreciate that they actually got me through pretty quickly. It's just that everything they did required me to either think or sit, and I wasn't in much of a mood to do either. Once I got processed, the ER nurse asked me to get in a wheelchair for the trip up to the birthing center, but there was no way I was going to do that. I refused as politely as I could, over her repeated insistence that it was a pretty long walk. I compromised and said she could bring the chair along, and that seemed to make her feel better. I was mostly between contractions anyway, so we got up there fairly quickly.

My memory gets a little hazy once we arrived at the birthing center. I felt like we walked off the elevator and into my room, although I realized afterward that there was quite some distance between those two points. We then met Angela (not her real name, but she was an angel, so …), the nurse who would be with us throughout the rest of labor and delivery. I got changed into a gown, which bothered me a little because for some reason, I'd become really attached to the t-shirt of The Husband's I was wearing. Angela let us know that she'd have to run a monitor strip and put in an IV. I told her that my doctor said I wouldn't have to have an IV, so she called to check on that (I doubted it at the time, but I believe her now) and said Dr. Hippie did want a heparin lock put in just in case I needed fluids or medications later. So when I was in between contractions - she was wonderful about not forcing me to do anything while I was in the middle of a contraction - she strapped on two monitor belts and put in the hep lock. At that point, I fully understood every woman who ever requested an epidural, because lying there with those belts on made the contractions exponentially more difficult to handle. I had just enough mobility that I could still stand up and move a little, though, so I got out of bed as soon as they'd let me and I walked around the best that I could. It was hard, though - the increased pain from the belts plus the fact that I was leaking blood and amniotic fluid on the tile floor made it pretty difficult to position myself. I kept asking and asking for the belts to be removed, and Angela got them off as soon as she could. She checked me and I was elated to find out I was eight centimeters dilated.

From then on, it's all pretty fuzzy - partly because I had my glasses off and/or my eyes closed most of the time. The Husband, The Doula and Angela were all wearing blue shirts, so I remember that there was always a blue blur of some varying size somewhere near me. Because we were in such a hurry to get into the hospital, we left almost all of our carefully packed birth kit in the car. The Doula went down to get the birth ball and yoga mat, and apparently got lost on the way back, so it's not just my convoluted sense of time that made it seem like she was gone forever. I wasn't able to get much use out of the birth ball by then, but the yoga mat was really helpful, because sometimes the only place I felt like being was on the floor, and tile gets pretty uncomfortable after awhile (although, at the time, my knees were pretty low on my priority list). I started getting frightened and less in control. The Doula gave me some flower essence, which was about as close as I’d let anyone get to me. The Husband, The Doula and Angela all stayed near me, but could tell I didn’t want them in my space.

My moans got deeper and louder, and eventually turned into growls. I was somewhat relieved to hear that I was the only person in the birthing center that night, because it made me less inhibited about using my voice. It really was helpful to bellow out during the contractions. It didn't erase the intensity, but it took some of the edge off. I also walked around in circles, rocked back and forth, and at one point, started twirling around like a demented Phish fan. Which made poor The Husband and The Doula very nervous - I was unsteady on my feet as it was. But I felt like the centrifugal force would help some, and that it did. I also did a lot of squatting on the couch, and tried at one point tried to hang from the TV armoire. A birthing bar or hanging rope would have really been a help to me - I really needed to get my arms up and make myself as long as I could. I was hot and sweaty and desperately thirsty, but the ice chips I was allowed to have just made me feel nauseous. The Doula got a cool washcloth for me, and that helped tremendously. I also kept fanning myself with my gown between contractions. What they say about losing all modesty during labor is true – I didn’t care for a second that my entire lower body was exposed, and in fact, I probably would have been even happier if I’d been completely naked.

Angela would quietly step in and monitor me with a Doppler whenever I had a break between contractions. Again, she was amazing at reading where I was at and not making things any harder for me. Dr. Hippie was called and arrived after I'd been there for

about an hour. He stayed very much in the background, though. Apparently he stepped just inside the room, observed for a while and then mentioned that he didn't want to rush me, but I don't really remember anything but seeing a brief glimpse of him and hoping we'd need to call him back in soon. When I felt like I was unable to refrain from pushing any longer, I asked to be checked again - I was at nine and a half centimeters, just short of full dilation. Getting that last little bit of cervix out of the way was probably

one of the toughest obstacles I had to get through. I felt like my entire lower abdomen was being clutched by something strong and hot. There was a tremendous amount of pressure during the contractions, and trying not to push made it harder to focus on pain

relief techniques.

We finally decided I was close enough to complete, and I was ready to start pushing. I didn't really want to get into the bed, but there wasn't really anywhere else to go and Angela felt more comfortable with me there. I started out pushing in sort of a modified hands and knees position, with my arms over the back of the raised head of the bed. It was a relief to push, although definitely intense in its own right. And much messier than the contractions alone - I was not only bleeding all over myself, but now that I was focusing on bearing down, anything smaller than a baby that could possibly come out of me tried to do so. Funny how quickly you get over the embarrassment of pooping yourself in public, though. Once I realized how much more effective pushing was if I just gave it my all and didn't worry about what came out, the better I was able to move the baby down. I had no idea how to push out a baby, but I knew how to poop, damn it. So that's what I focused on, for better or worse. (Angela, who was very supportive and did not say a single pitying thing throughout labor, did mutter "Her hemorrhoids are going to give her more fits than anything else.") I bled, I peed, I pooped and I pushed. Over and over and over again.

I tried not to look at the clock, but I could tell I’d been working for a while. Pushing alone was better than getting through the contractions, but in between each push, my back was screaming. I was too disoriented to remember the physiology involved with getting a baby through my pelvis – I just thought my position and fatigue were the cause of the pain. It didn’t really occur to me that my pelvis and lower spine were all flexing and moving around.

After about an hour and a half (I think), Angela and The Doula suggested that I try a different position to help the baby wiggle into a better position, so I tried lying on my side with The Husband supporting my top leg and widening my pelvis while I was pushing. This felt pretty productive, but with no counter-pressure on my back between contractions, I couldn’t maintain the position for long. So I eventually ended up in the last place I expected – on my back with my legs pulled up. Angela supported my perineum with a warm compress and performed perineal massage between contractions. It was a vaguely aggravating sensation, but once I figured out what she was doing and knew it would help me, I just dealt with it. Besides, it was nothing compared to what was going on in my back. I had a folded towel wedged behind the small of my back, and I kept begging The Husband to push on my lower back when he wasn’t busy helping to support my legs. His hand must have been under me for nearly an hour, and I knew it couldn’t be comfortable for him, but it was the only relief I got from the sharp, spasm-like pain radiating out of my spine. Everyone kept telling me how close the baby was, which made me expect that I’d be seeing the head any minute. But then I didn’t.

It seemed like I was trying to go the wrong way up an escalator, but eventually Dr. Hippie started appearing more frequently, and I could tell from the activity around me that I must be getting close. Angela brought over a mirror so I could see the baby, but there was barely anything to see. I felt both discouraged and defiant. I started making more noise during pushes, clutching the handrails of the bed and doing the best I could to curl myself around the baby. The Doula and The Husband held my legs through each bout of pushing, and they were both talking more and encouraging me to push through the part of each contraction where I felt most tempted to stop.

The environment suddenly got much more medical. Bright lights were focused on my bed, and two new nurses appeared and slid plasticky sheets under me. Those two factors, plus the intensity of pushing, made me unable to handle the heat, so I pulled my gown over my head and lay there completely naked. Dr. Hippie reappeared and got into position at the foot of the bed. He watched me work through a few more contractions and happily announced “Looks like I won’t get to do surgery.” The new nurses began directing me through pushing, telling me to hold my breath and use that power to increase my pushing strength. Problem was, I knew I didn’t want to hold my breath for longer than 5-6 seconds at a time, but no one was counting for me, so I kept getting winded. This was the part of labor that was least like the way I’d imagined it. I’d hoped for a peaceful delivery, ideally with dimmed lights and only quiet, supportive verbal encouragement. Instead, I was baking under floodlights and having strangers boss me around.

Fortunately, it didn’t last all that much longer. My entire lower body felt completely full and stretched, although I’m pleased to report that I didn’t feel like I was coming apart at the seams, and I kept waiting for a “ring of fire” sensation that never came. I think the extended length of my pushing actually helped, because there was plenty of time for the baby to put pressure on those nerves, which helped to numb them. I got to the point where Dr. Hippie said “This will be over in three minutes, two minutes or one minute – it’s up to you.” I’d already been pushing for over two and a half hours, so I voted for one minute. I pushed almost constantly, whether I felt a strong urge or not. Every sensation got more intense, but I was so focused on seeing the baby that I was able to push back almost the entire perception of pain. (Emphasis on almost.)

And then it was there. I looked down and could see the head (thankfully, someone had brought me my glasses by then). It didn’t come out all at once like I expected, but within two or three pushes, it was completely delivered. In the next push, the shoulders were free and, at 6:54 am, the entire body was out. Dr. Hippie quickly turned the baby to face us – he didn’t announce the gender, preferring instead to hand her over to us and let us make the realization on our own. I barely remember what came out of my mouth, but I think I said “We have a girl.”

The nurses dried her off while she was still on my chest, and then wrapped her as best they could without taking her from me. Even after having seen her come out of me, I still couldn’t really fathom that she had any connection with what I’d just experienced. The Doula and Angela helped me to start nursing her while Dr. Hippie prompted me to deliver the placenta and then prepped me for the suturing of a small tear. Neither of these things was especially comfortable, so it was all the more pleasant to have the baby so close to me and helping to distract me. He let the cord stay intact for a while, and then I vaguely remember him asking if The Husband wanted to cut the cord. I was just starting at the baby the entire time.

I finally turned to The Husband, who was not trying to hide the tears in his eyes, and asked what she looked like. We still hadn’t fully settled on a girl’s name, so we had to make a final decision. We looked at her together and agreed that she’d be well suited by the name Meredith Harper – Meredith after my godmother, and Harper after the greatest one-time novelist in American literature (and a pretty bad-ass Southern woman to boot). I held and nursed her for nearly an hour before a nurse asked to weigh and examine her. As I saw her across the room, I tried to absorb her existence. We had a daughter. I was a mother. It still didn’t seem entirely real, but when I heard a nurse call her by name, or felt her clutch at my skin when she was returned to my arms, I knew she was mine.

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